2011 Grunt Run

OPEN TO THE GENERAL PUBLIC FREE TO ACTIVE DUTY!

2011 Nearly five five miles miles of of brutality brutality Nearly designed to to push push your your body body to to its its limits limits designed

SATURDAY, OCTOBER 15 AT 8:30 8:30 A.M.

Mid-Atlantic Region

SPONSORED BY:

NSA NORTHWEST ANNEX, 4541 RELAY ROAD CHESAPEAKE, VIRGINIA 23322 Race day registration begins at 6:30 a.m.

The U.S. Navy does not endorse any company, nor sponsor their product or service. and ends at 8:15 a.m. on-site.

Experience obstacles, rough terrain, climbs, swamps and other challenges under the watchful eyes of your personal drill instructors.

Military Community - Active duty, retirees, reservists, AGE GROUPS FOR eligible family members and DoD civilians without T-shirt MEN AND WOMEN: THROUGH SEPTEMBER 2 - Military Community with T-shirt - $10 per person, 14 and younger General Public without T-shirt - $15 per person, General Public with T-shirt - $25 per person 15 to 19 20 to 24 THROUGH SEPTEMBER 16 - Military Community with T-shirt - $12 per person, 25 to 29 General Public without T-shirt - $17 per person, General Public with T-shirt - $25 per person 30 to 34 35 to 39 THROUGH OCTOBER 11 - Military Community with T-shirt - $15 per person, General Public with T-shirt - $30 per person 40 to 44 THROUGH OCTOBER 12 - General Public without T-shirt - $20 per person (T-shirts will not be available if you have not 45 to 49 registered by October 11) 50 to 54 INDIVIDUAL OR TEAM COMPETITION. TEAMS MAY BE COMPRISED OF THREE TO FIVE PEOPLE. 55 to 59 IF YOU COMPETE AS PART OF A TEAM, THERE IS AN ADDITIONAL COST OF $5 PER PERSON. 60 and older RACE PACKET PICK-UP DATES (AT RACE SITE) - For all military community, government I.D. checked at packet pick-up for verification purposes.

FREE!

ENTRY FEES:

REGISTER AT RACEIT.COM

Friday, October 14 from 3 p.m. to 7 p.m. and Saturday, October 15 from 6:30 a.m. to 8:15 a.m.

NSANW-07-04-JW

CALL 421-8263 FOR MORE INFORMATION. STAY CONNECTED! www.cnic.navy.mil/nwannex/mwr Visit MWR online for the latest on events and activities at Northwest Annex.

Interactive Customer Evaluation We need your feedback! http://ice.disa.mil

REGISTRATION FORM AND ADDITIONAL DETAILS ON BACK. Become a fan of “Commander, Navy Region Mid-Atlantic” on Facebook!

Grunt Run 2011 Saturday, October 15, 2011, 8:30 a.m. at NSA Northwest Annex Please return entry forms to: NSA Northwest Annex MWR Department, Olympic Blvd., PO Box 697 MOU#1, Chesapeake, Virginia 23322 BASE ACCESS - Registrants will be contacted via email, two weeks prior to this event with detailed instructions on how to obtain access to the base.

Name ______________________________________________________________________________________________________ Age __________________ Sex ________________ Work Phone ____________________________________________ Home/Cellphone _____________________________________________________ E-mail _________________________________________________________________________________________________________________ T-shirt size: Small _____ Medium _____ Large _____ XL _____ XXL _____ COST: Military Community without T-shirt, FREE ____ Active duty personnel

____Retiree

____Reservist

____Qualifying family member

____DoD civilian

COST FOR ALL OTHERS (PER PERSON): THROUGH SEPTEMBER 2

THROUGH SEPTEMBER 16

THROUGH OCTOBER 11 (T-shirt cut-off date)

____ Military Community with T-shirt - $10 per person

____ Military Community with T-shirt - $12 per person

____ Military Community with T-shirt - $15 per person

____ General Public without T-shirt - $15 per person

____ General Public without T-shirt - $17 per person

____ General Public without T-shirt - $20 per person

____ General Public with T-shirt - $25 per person

____ General Public with T-shirt - $25 per person

____ General Public with T-shirt - $30 per person

THROUGH OCTOBER 12 ____ General Public without T-shirt - $20 per person (T-shirts will not be available if you have not registered by October 11)

Will you be participating as part of a team? Yes __________ No __________ TEAMS MAY BE COMPRISED OF THREE TO FIVE PEOPLE. IF YOU COMPETE AS PART OF A TEAM, THERE IS AN ADDITIONAL COST OF $5 PER PERSON. PLEASE PUT EACH TEAM MEMBER’S REGISTRATION FORM ALL TOGETHER IN A SINGLE ENVELOPE AND SUBMIT AS A WHOLE. Team name ______________________________________________________________________________________________ Your team member fee ($5) _____ Team member 1 ________________________________________ Team member 2 ________________________________________ Team member 3 ________________________________________ Team member 4 ________________________________________ Team member 5 ________________________________________ Please make checks payable to MWR FUND.

Total enclosed ______________

In consideration of acceptance of this entry, I, the below signed, intending to be legally bound for myself, my heirs, executors and administrator waive and release all rights and claims for damages and personal injury that I may have against the facility and any persons and all sponsors, organizers, and their representative, successors, and assign for any and all injuries suffered by me in traveling to, performing in, and traveling from said event. I verify that I am physically fit and have trained for this event and my condition has been verified by a licensed medical doctor.

Signature________________________________________________________________________________ Date___________________________ If under the age of 18, parent/guardian signature _______________________________________________________ Date _________________________